Provider Demographics
NPI:1659666014
Name:DO, NICHOLAS THU KHOA (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:THU KHOA
Last Name:DO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:NICHOLAS
Other - Middle Name:
Other - Last Name:DO MD INC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8231 WESTMINSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3364
Mailing Address - Country:US
Mailing Address - Phone:714-328-2344
Mailing Address - Fax:
Practice Address - Street 1:200 UCLA MEDICAL PLZ STE 460
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-2004
Practice Address - Country:US
Practice Address - Phone:310-825-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1680462086S0122X
MI4301116711390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery